DAY:

CELL:

LEVEL

STUDENT STATEMENT: In consideration of SIUC reserving space for me in class(es) listed above and subject to the enrollment conditions stated in the Schedule of Classes, I agree to maintain an accurate address to which a statement of my account can be mailed and to make prompt payment of all currently due accounts. I understand that failure to receive a bill does not relieve me of those responsibilities. I further understand that if I do not pay tuition, fees and other charges according to the payment plans described in the Schedule of Classes, this registration may be cancelled.

MILITARY PROGRAMS STUDENTS: I agree to maintain an accurate address to which my statement of account will be sent and to promptly pay all charges. Failure to receive a statement does not relieve me of this responsibility.

STUDENT SIGNATURE DATE STUDENT NAME (PRINTED)

ADVISORS SIGNATURE DATE ACADEMIC DEAN SIGNATURE DATE

COLLEGE / UNIT

SITE

OFFICE USE

APPROVAL OF ACADEMIC DEAN REQUIRED FOR OVERLOAD, LATE ADD OF COURSE OR DROP FROM A

CLASS OTHER THAN CURRENT DATE

DATENAME

DROP DATE MONTH DAY

TOTAL CREDIT HOURS

DAWG TAG

EMAILPHONE NUMBERADDRESS

HOURSLEVEL

STUDENT SIGNATURE DATE STUDENT NAME (PRINTED)

ADVISORS SIGNATURE DATE ACADEMIC DEAN SIGNATURE DATESTUDENT STATEMENT: In consideration of SIUC reserving space for me in class(es) listed above and subject to the enrollment conditions stated in the Schedule of Classes, I agree to maintain an accurate address to which a statement of my account can be mailed and to make prompt payment of all currently due accounts. I understand that failure to receive a bill does not relieve me of those responsibilities. I further understand that if I do not pay tuition, fees and other charges according to the payment plans described in the Schedule of Classes, this registration may be cancelled.

MILITARY PROGRAMS STUDENTS: I agree to maintain an accurate address to which my statement of account will be sent and to promptly pay all charges. Failure to receive a statement does not relieve me of this responsibility.

SITE

OFFICE USE

TOTAL CREDIT HOURSAPPROVAL OF ACADEMIC DEAN REQUIRED FOR OVERLOAD, LATE ADD OF COURSE OR DROP FROM A CLASS OTHER THAN CURRENT DATE.

DROP DATE

MONTH DAY COLLEGE / UNIT

ADDRESS PHONE NUMBER EMAIL

DAWG TAG NAME DATE